What can Go Wrong When an Thyroid Ultrasound finds a Nodule?

What can Go Wrong When an Thyroid Ultrasound finds a Nodule?

What can Go Wrong When an Thyroid Ultrasound finds a Nodule?

The top two ultrasounds describe a 1 cm nodule between the markers.

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The ultrasounds from my center above shows no nodule but the presence of an area that is not a nodule but a incompletely ringed area that is that is a pseudo-nodule that is not an indication for a biopsy.The patient had a biopsy and was told to have surgery when  it was not a nodule and she should not have had an ultrasound or biopsy in the first place. She was saved from an unnecessary surgery by asking and finding an outside expert to review her case.

What can Go Wrong When an Thyroid Ultrasound finds a Nodule?

The patient had no findings for an indication to do an ultrasound, but one was done. The result was a 1 cm nodule seen in a lobe. The patient has Hashimoto’s thyroiditis by antibody and TSH testing. There was no findings of a nodule on physical examination. The primary and endocrinologist recommended a biopsy, and after a very painful biopsy was told it was suspicious. They wanted her to repeat the biopsy with molecular markers. She opted for an outside opinion. The detailed repeat thyroid and neck ultrasound confirmed Hashioto’s thyroidtis, but the so called nodule was an area of pseudo-nodular changes of Hashimoto’s not a real nodule. The ultrasound was misleading and the biopsy was on necessary. The suspicious changes was some Hurthle cells which are normally a part or Hashimoto’s not a hurthle cell tumor or cancer.

What did we learn?

Refuse thyroid ultrasound without good clinical reasons. Refuse biopsy without an outside expert opinion.And when it was done and they want you to have surgery have the slides and ultrasound reviewed by an expert thyroidologist before you go under the knife. This was not a nodule and they did not need another biopsy.When she refused they threatened to dismiss her as a patient.

 

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